MP09-07 DOES ELECTRICAL STIMULATION IN THE LOWER URINARY TRACT INDUCE DIURESIS?

Abstract

You have accessJournal of UrologyBladder & Urethra: Anatomy, Physiology & Pharmacology I1 Apr 2018MP09-07 DOES ELECTRICAL STIMULATION IN THE LOWER URINARY TRACT INDUCE DIURESIS? Stéphanie van der Lely, Martina D. Liechti, Werner L. Popp, Thomas M. Kessler, and Ulrich Mehnert Stéphanie van der LelyStéphanie van der Lely More articles by this author , Martina D. LiechtiMartina D. Liechti More articles by this author , Werner L. PoppWerner L. Popp More articles by this author , Thomas M. KesslerThomas M. Kessler More articles by this author , and Ulrich MehnertUlrich Mehnert More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.333AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Electrical stimulation of the lower urinary tract (LUT) is typically used to assess current perception thresholds and sensory evoked potentials to investigate LUT afferent function. However, changing bladder volume during measurement may influence the outcome. We therefore aimed to quantify urine production during LUT electrical stimulation using different stimulation frequencies. METHODS After local ethics committee approval, 89 healthy subjects (23.9±3.7years, 49 females (f)) were included. All subjects completed a 3-day bladder diary. LUT stimulation site was randomly assigned: bladder dome (n=20), trigone (n=20), proximal urethra (n=20), membraneous urethra (n=10, males (m) only), and distal urethra (n=19). After catheter placement the bladder was emptied and refilled with 60mL of contrast medium. Current perception threshold assessment followed by electrical stimulation was applied at two separate visits with a 14Ch custom-made catheter using three different frequencies (500 stimuli - 0.5Hz (16.7min), 1.1Hz (7.6min), 1.6Hz (5.2min)) in random order. After each stimulation session, the bladder was emptied again and volumes were recorded. To control for different stimulation times, urine production per time was analyzed. Linear mixed effects modeling was used to estimate the impact of specific variables on bladder volume increase, i.e. urine production per time, during electrical stimulation in the LUT. RESULTS Compared to average natural diuresis over 24 hours as assessed by bladder diary (1.4±0.6mL/min for f and 1.3±0.8mL/min for m), urine production per time increased (p<0.001) in average to 11.9±7.5mL/min in f and 9.2±8.2mL/min in m during electrical stimulation. With 0.5Hz stimulation, urine production per time increased by factor 6.5 compared to the bladder diary values, while it increased by factor 11.6 when stimulating with 1.6Hz. Stimulation frequency (p<0.001), stimulation order (p=0.002), and stimulation intensity (p=0.021) had a significant influence on urine production per time and was different between genders (p=0.024), while stimulation location and visit had no statistical significant influence. CONCLUSIONS Electrical stimulation in the LUT significantly increased urine production per time with a bigger impact of higher frequencies. This might not only be relevant for methodological aspects in the assessment of LUT afferent function but also for patients with impaired urine output. The exact mechanism behind our finding is still unclear, but may involve vagal afferent activity (N. Morgunov, Canadian J Physiol Pharmacol 1985, 63(6):636-641). © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e108 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Stéphanie van der Lely More articles by this author Martina D. Liechti More articles by this author Werner L. Popp More articles by this author Thomas M. Kessler More articles by this author Ulrich Mehnert More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...